Individual provider Active NPI

Krystin Shand

  • Registered Nurse
  • Massapequa Park, NY
National Provider Identifier
1578992665
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
676139 Issued in NY
Practice address
161 Jerusalem Ave
Massapequa Park, NY 11762-1702
Phone
(516) 469-5476
NPI assigned
Nov 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 676139 NY Primary

Addresses

Primary practice location

161 Jerusalem Ave
Massapequa Park, NY 11762-1702

Mailing address

161 Jerusalem Ave
Massapequa Park, NY 11762-1702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
676139NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1578992665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 JERUSALEM AVE",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117621702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 JERUSALEM AVE",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117621702",
            "telephone_number": "516-469-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAND",
        "first_name": "KRYSTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "676139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.